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Taking prednisone before sleep.

Polymyalgia Rheumatica (PMR) | Last Active: 3 days ago | Replies (8)
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@tuckerp

I agree with Jeff97. I doubt whether your taking enough of the steroid. 2 months is not a very long time to go into remission. If you are taking Actemra that can take up to 6 months to start helping. Actemra does not work for everyone. You may have to try something else. The Dr. must have suspected GCA if you started at 60mg . That is a pretty heavy dose to control PMR. You need to google "prednisone and circadian rhythm". After 2 weeks your body has quit making cortisol. The cortisol comes from the steroid. Your body is able to produce cortisol whenever you need it. Its used for most of your critical functions. You are now supplying just one predetermined dose. I switched to Dexamethasone. Cancer patients use it. The Dr did not want to but switched for me. 2mg of Dex is equivalent to 10mg prednisone. You adjust the dose accordingly. Dex has a longer half life. Blurry vision was one of my side effects of the prednisone. It does clear up. I was also not able to taper from 10mg prednisone for 5 months. Then over the 6 month tapered very quickly to zero. I felt I was pretty lucky. 2 months is not enough time.

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frenchfrank51 | @frenchfrank51 | 3 days ago

Thanks tuckerp.
Thanks tuckerp for those explanations. You've obviously been dealing with this much longer than myself and what you've described helps me to get my head around it somewhat.

The reason, I think, I was started on 60mg was because I had a particularly bad spell of pain and stiffness over a day or two (on top of my usual levels of pain and stiffness caused by a fair amount of arthritis and tendon damage and muscle pain ) which meant I couldn't do anything at all without my wife helping me. Couldn't get out of bed, couldn't put my socks on, couldn't walk. No strength anywhere but a lot of pain. By chance, I'd had a lot of blood tests done just a day or two before which were so bad the laboratory rang me and told me to see my doctor ASAP. Amongst lots of blood markers being too high or too low than they normally are, my CRP was 178. So, something had to be done pretty quickly. No real reason for the hike in CRP was found or given. At the last blood test a week or so ago it's down to 17. GCA was tested for when PMR was diagnosed and it was dismissed....twice.

No doubt yourself and JEFF are probably correct about not being on high enough a dose and I'll have to go back up a notch or two. It won't be the first time even in my short time on prednisone.

I had my second weekly injection of Actemra yesterday so a long way to go yet with that. I do hope it does work.

Dexamethasone I've not heard of but about 2 years ago I was prescribed methotrexate by injection for my arthritis problems but only lasted 7 weeks. I felt so ill I had to stop but never knowing if the methotrexate was making me feel worse or whatever else I was already suffering from was just taking its toll. I Imagine those two drugs are similar.

I do get the impression my blurred vision was less of a problem this morning because I didn't take my prednisone dose with breakfast. I'll take it again with my evening meal and try 10mg this time. I suppose I'll soon know if it makes a difference.

Thanks again for your help.

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